State of Lung Cancer: New Report Reveals Hawaiʻi Worst in Nation for Early Diagnosis

Today, the American Lung Association in Hawaiʻi released the 2025 “State of Lung Cancer” report, which reveals that more needs to be done to end the burden of this devastating disease on families throughout the state. Lung cancer is the leading cause of cancer deaths here in Hawaiʻi and across the U.S. The report finds that Hawaiʻi ranks last in the nation for diagnosing lung cancer in its earlier, more treatable stages. And while reported new cases are lessening, many with the disease have received no treatment.

The Lung Association’s eighth annual “State of Lung Cancer” report highlights how the toll of lung cancer varies by state and examines key indicators throughout the U.S., including new cases, survival, early diagnosis, surgical treatment, lack of treatment, screening rates and insurance coverage of comprehensive biomarker testing.

The report found that Hawaiʻi ranks:

• 5 out of 51 in the nation for rate of new lung cancer cases, at 38.2 per 100,000. The national rate is 52.8 per 100,000.
• 26 out of 39 in the nation for survival, at 27.2%. The national rate of people alive five years after a lung cancer diagnosis is 29.7%.
• 50 out of 50 in the nation for early diagnosis, at 21.8%. Nationally, only 28.1% of cases are diagnosed at an early stage when the survival rate is much higher.
• 39 out of 51 in the nation for lung cancer screening, at 14.9%. Lung cancer screening with annual low-dose CT scans for people at high risk can reduce the lung cancer death rate by up to 20%. Nationally, only 18.2% of people at high risk were screened.
• 42 out of 49 in the nation for surgery as first course of treatment, at 16.1%. Lung cancer can often be treated with surgery if it is diagnosed at an early stage and has not spread. Nationally, 20.7% of cases underwent surgery.
• 38 out of 49 in the nation for lack of treatment, at 23.6%. Nationally, 21% of cases receive no treatment.

“In the last decade, we have seen incredible progress, including increases in lung cancer survival and early detection rates. This means that more people in Hawaiʻi are living longer after a lung cancer diagnosis,” said Pedro Haro, Executive Director for the American Lung Association. “While this progress gives us hope, early detection and survival rates are far too low in our state. Working to increase awareness and access to lung cancer screening and biomarker testing are critical to saving lives. This is why the state must step in to ensure their residents have access to the best lung cancer care.”

The “State of Lung Cancer” report also examines insurance coverage of comprehensive biomarker testing across the U.S. Lung cancer biomarker testing, sometimes referred to as tumor, molecular, genomic or genetic testing, looks for changes in the tumor's DNA. The results of the test may show biomarkers that can help determine what treatment options would be best for an individual patient. Insurance coverage of biomarker testing is important for removing a cost barrier to people with lung cancer, but coverage for biomarker testing is only required in some states. The report found that Hawaiʻi does not require insurance coverage of comprehensive biomarker testing.

The 2025 “State of Lung Cancer” report highlights opportunities for states to reduce the burden of lung cancer and encourages everyone to help end lung cancer. This year, the American Lung Association calls for the state to implement policies to require insurance coverage of comprehensive biomarker testing. Learn more about the report and take action at Lung.org/solc.

Get involved and help the mission of the American Lung Association. Each May, the American Lung Association in Hawaiʻi celebrates extraordinary women at the Breath of Motherhood Awards in May. Visit us online to learn more and to get involved today.